Starmer Heather, Edwards Jeffrey
Department of Otolaryngology - Head and Neck Surgery, Stanford University, Palo Alto, California.
Head and Neck Speech and Swallowing Rehabilitation, Stanford Cancer Center, Palo Alto, California.
Semin Speech Lang. 2019 Jun;40(3):213-226. doi: 10.1055/s-0039-1688979. Epub 2019 Jun 3.
Dysphagia is a common challenge faced by patients with head and neck cancer. Management of these patients is quite distinct from many other dysphagia etiologies due to the nature of surgical removal of organs critical to swallowing, the ability to provide preventative therapies, and the variable risk for complications related to dysphagia. Thus, clinicians providing care to the head and neck cancer population need to understand these differences when employing clinical decision making. In addition, changes in the demographics of head and neck cancer, related predominantly to the epidemic of oropharyngeal cancer associated with the human papillomavirus, have further transformed both the types of patients and the types of treatments offered. These epidemiologic factors further complicate the decision-making process for clinicians. This article provides a framework for decision making in the surgical and nonsurgical patient with head and neck cancer.
吞咽困难是头颈癌患者面临的常见挑战。由于对头颈癌患者进行吞咽关键器官的手术切除的性质、提供预防性治疗的能力以及与吞咽困难相关的并发症的可变风险，对这些患者的管理与许多其他吞咽困难病因有很大不同。因此，为头颈癌患者提供护理的临床医生在进行临床决策时需要了解这些差异。此外，头颈癌人口统计学的变化，主要与人类乳头瘤病毒相关的口咽癌流行有关，进一步改变了患者类型和所提供的治疗类型。这些流行病学因素使临床医生的决策过程更加复杂。本文为头颈癌手术和非手术患者的决策提供了一个框架。
